Change of travel information form

1. This form is no longer in use. Please complete a new pre arrival form on travel tracker or contact Email: travel.tracker@gov.gg Phone: 01481 220001 for more support.
Please use the form below to tell us if you are self-isolating
1. Name*
2. Date of birth (DD/MM/YYYY)*
3. Mobile number you can be contacted on in the Bailiwick*
4. Email address*
5. Date arrived in the Bailiwick (DD/MM/YYYY)*
6. Reason for change in travel history e.g. weather disruption*
7. Details of other travellers in your family/group that this change affects* Please include full name and date of birth for each traveller
8. Revised travel history – detailing all travel in the 7 days prior to arrival in the Bailiwick.
9. Country/region visited:*
10. Date(s) when you spent time there:*
11. Direct transit? *
  
  Yes
  
  No
12. Declaration: I confirm that I have provided true and accurate information, and that I understand that a person who has provided false or misleading information may be prosecuted and, if convicted, be sentenced to pay a fine of up to £2,000.
13. Please tick box to confirm you have read and understood the declaration above*
14. The States of Guernsey, the States of Alderney and the Chief Pleas of Sark, and any of their Committees, (where relevant) may process your data for the purpose of testing, prevention, control and mitigation of the risks to life and public health posed by the disease COVID-19. Each area of the organisation will require a different level of information about you, but all will use the minimum necessary to do what they are required to. Further information about how your personal data is processed in relation to the COVID 19 pandemic by the States of Guernsey can be found at covid19.gov.gg/privacy or alternatively a hard copy can be requested.

St Peter Port & St Sampson

All Other Parishes

Change of travel information form